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A  BRIEF  SYNOPSIS 


OF  S03IE  OF  THE 


LECTURES  ON  ANATOMY 


GIVEN  BY 


PROF.  C.  L.  FORD,  M.  D. 


UNIVERSITY  OF  3IICHIGAN. 


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A  BRIEF  SYNOPSIS 


OF  SOME  OF  THE 


LECTURES  ON  ANATOMY 


RIVEN  BY 


PROF.  C.  L  FORD,  M.  D., 

TJNIVEESITY  OF  MICHIGAN, 

1883. 


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COURIER  BOOK  AND  JOB  PRINTING  HOTTSE,    ANN  ARBOR. 


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A  WOED  OF  EXPLANATION. 


I  have  been  in  the  habit  for  years  of  placing  on  the 
black-board  a  synopsis  of  each  lecture. 

The  requests  to  have  these  printed  have  been  so  fre- 
quent, that  I  have  decided  to  comply  with  that  wish, 
and  try  the  experiment  of  enabling  each  student  to 
have  at  hand  a  copy,  in  the  hope  of  aiding  to  follow, 
and  more  readily  review,  the  lectures  afterwards. 

If,  in  this  respect,  my  hopes  seem  to  be  realized,  I 
will  at  another  time  extend  the  series  more  nearly  to 
embrace  the  topics  discussed  in  the  entire  course. 

While  these  notes  by  no  means  include  all  matters 
considered,  they  indicate  the  general  plan  pursued,  in 
displaying  parts  by  dissection  in  the  lecture  room. 


DISSECTION  OF  THE  ABDOMEN. 


What  to  study  on  the  abdomen. 
Mode  of  preparing  it  for  dissection;  objects. 
Boundaries  of  zones,  imaginary  lines :  where  S 
Perpendicular  lines,  where  drawn,  regions. 
Reasons  for  thus  dividing  the  surface. 
Umbilicus,  what  is  it?  where  is  it?  appearance. 
Blood-vessels  in  and  beneath  the  skin,  where  ? 
What  nerves,  and  from  what  source  derived  ? 
Where  do  the  lymphatics  of  the  region  pass  ? 
Structure  next  beneath  the  skin,  nature. 
Fascia,  composition,  what  layers  ?  fleshy,  thin. 
Muscles  of  the  abdomen  to  be  studied: 
L  Lateral  group  of  muscles  on  the  abdomen. 

1.  External  oblique, 

2.  Internal  oblique, 

3.  Transversalis, 

4.  Quadratus  lumboram. 
II.  Anterior  group  of  muscles . 

1.  Pyramidalis, 

2.  Rectus  abdominis. 
Regions  demanding  special  attention- 
Principally  two,  umbilical  and  inguinal. 

5 


IMPORTANT  SURGICAL  REGIONS. 


Inguinal  region ;  location  ? 
Inguinal  hernia.    What  is  hernia  ? 
Parts  to  be  studied  on  the  cadaver. 
Muscles  involved  in  permitting  hernia. 

External  oblique, 

Internal  oblique, 

Transversalis. 
Cause  and  nature  of  weakness  of  the  parts. 
Obliquity  of  passage  an  element  of  safety. 
What  and  where  is  Poup art's  ligament  ? 
In  what  structure  is  the  external  abdom.  ring? 
Where  is  ring  situated:  distance  from  centre  ? 
What  is  the  size  and  shape  of  the  opening  ? 
How  can  we  examine  it  during  life  ? 
What  are  the  boundaries  of  the  ring  ? 
Nature  of  external  and  internal  pillars. 
Inter-columnar  fascia;  what  and  where  ? 
Structure  passing  the  opening;  size  of  cord. 
What  conceals  the  opening  at  first  ? 
What  its  relation  to  spine  of  the  pubis  ? 
Important  to  distinguish  hernia  and  varicocele. 
How  trusses  may  do  injury  to  one. 

6 


HERNIAL  REGION,  Continued, 


Review  the  parts  studied  yesterday. 
Inguinal  canal,  occupied  by  cord. 
Its  length,  one  and  a  half  to  two  inches. 
Direction  upwards  and  outward. 
Size  varies  with  the  cord.    Results  of  fat. 
Boundaries  of  the  inguinal  canal,  what  ? 
Anteriorly :  tendon  of  external  oblique  m. 
Superiorly :  internal  oblique  and  transversalis. 
Inferiorly:  Poupart's  ligament;  shape. 
Posteriorly:  transversalis  fascia  &  conj.  tend. 
Internal  ring;  its  location;  appearance. 
In  what  structure  ?    How  arranged  ? 
How  are  the  rings  protected  against  hernia  % 
Internal  epigastric  artery;  where  found. 
Its  origin,  direction,  distribution,  size  ? 
Ordinary  coverings  of  Hernia: 
Direct.  Oblique. 

1.  Skin.  1.  Skin. 

2.  Superficial  fascia.   2.  Superficial  fascia. 

3.  Intercolutn,  fascia.  3.  Intercolumnar  fascia. 

4.  Conjoined  tendon.  4  Cremasteric  fascia. 

5.  Transversalis  f.       5.  Infundibuliform  f. 

6.  Peritoneum.  6.  Peritoneum. 

7 


ABDOMINAL  WALLS,  Continued. 


Dissection  of  abdominal  muscles. 

1.  External  oblique;  origin,  insertion,  action. 
Its  surrounding  relations;  interdigitations. 
Direction  and  termination  of  its  fibres. 

Its  aponeurosis— meaning  of  the  term. 

2.  Internal  oblique;  its  location.     O.  I.  A. 
Arrangement  of  its  tendon — how  united. 
Fan-shaped  arrangement  of  fibres.  Where? 

3.  Transversalis ;  parts  in  contact,    O.  I.  A. 
Its  fibres;  how  arranged  and  united. 

Its  tendon;  contribution  to  sheath  of  rectus. 

4.  Pyramadalis ;  location ;  not  constant.  O.I.  A.. 

5.  Rectus  abdominis;  location.     0.  I.  A. 
Sheath  in  which  it  is  enveloped;  thickness. 
Formation  of  its  front  layer.    How  ? 

Its  relations  to  the  linea  transversa. 
Relation  of  posterior  sheath  to  muscle. 
Linea  transversa;  nature,  number,  use. 
Linea  semilunaris.   Where  ?  How  formed  ? 
Linea  alba.     How  formed  ?    Meaning  ? 
Nature  of  opening  in  it.     How  closed  ? 
What  surgical  interest  has  it  'I    When  ? 

8 


OPENING  ABDOMINAL  CAVITY. 


Structures  outside  of  peritoneum. 
Fascia  transversalis;  nature,  use. 
Fascia  interna.     Cooper's  fascia.     Why  ? 
Where  relatively  most  important  ?    Why  ? 
Remains  of  urachus.     What  and  where  ? 
Remains  of  umbilical  arteries.     Where  ? 
Remains  of  umbilical  vein.     Where  ? 
Peritoneum;  appearance  as  opened. 
Objects  presented  at  first  view.     What  ? 
Objects  seeu  without  displacing  any. 
Peritoneum;  nature,  extent,  object. 
General  character  of  serous  membranes. 
Its  numerous  reflections.     Names. 
Omentum  majus.     Gastro-colic  omentum. 
Epiploon.    Purpose  of  it.    Location. 
Gastro-splenic  omentum.    Where  ?    How  ? 
Mesentery.    What  it  contains.    Uses. 
Moso-esecum;  meso-colon;  meso- rectum. 
Boundaries  of  abdominal  cavity;  shape. 
Contents  of  different  regions.     Exhibit. 
Attachment  and  mobility  of  organs. 
Modiiied  by  peritoneal  adhesions. 

9 


ALIMENTARY  CANAL,  DEFINE. 


Its  successive  portions.     Eleven. 

1.  Mouth.     Its  extent  and  general  purpose. 

2.  Fauces.     Location;  boundaries. 

3.  Pharynx.     Location;  connections. 

4.  (Esophagus.     Commencement;   ending. 

5.  Stomach.     General  character;  object. 

6.  Duodenum.     Its  location;  extent. 

7.  Jejunum.     Commencement;  character. 

8.  Ileum,    Meaning;  location;  termination. 

9.  Csecum.  Location;  appendix  vermiformis. 

10.  Colon.     Commencement;  course;  ending. 

11.  Rectum.    Location;  shape;  ending. 
Total  length  of  intestines :  great  variation ;  30  ft. 
General  structure  of  this  canal,  involuntary. 
General  purpose  which  it  serves. 

What  are  the  accessory  organs  ?    Where  ? 
Salivary  plands.    Name  and  location. 
Buccal  glands.    Labial  glands.    Where  ? 
Tonsils.    Location;  structure;  object. 
Pharyngeal  glands.    Location;  use. 
(Esophageal  glands.    Location;  extent. 
To  be  considered  in  another  connection. 

10 


ABDOMINAL  VISCERA. 


Stomach.    Its  nature  and  purpose. 
Its  universal  presence  in  animals ;  necessity. 
Its  immense  variety  of  modifications. 
Reqnired  by  great  variety  of  food. 
Its  simplicity  in  man;  in  carnivora. 
Its  complexity  in  herbivora — sheep. 
Essentially  a  dilatation  of  alimentary  canal. 
General  form  of  the  human  stomach. 
Its  orifices,  cardiac  and  pyloric;  location. 
Its  curvatures,  greater  and  lesser;  where  ? 
Its  surfaces,  anterior  and  posterior;  change. 
Its  length,  depth,  and  thickness;  12,  6,  3. 
Its  coats,  serous,  muscular,  cellular,  mucous. 
Its  alveoli  on  internal  surface;  nature. 
Immense  number.  Peptic  glands ;  peptic  cells. 
Arteries :  gastric,gastro-hepatic,gastro-splenic. 
Its  veins:  location;  destination  of  its  blood. 
Its  nerves :  pneumogastric  and  ganglionic. 
Structure  at  pyloric  orifice;  object. 
Its  connection  with  the  duodenum. 
The  aggregate  extent  of  the  inner  surface. 
Stomach  100  square  inches;  variation  great. 

11 


INTESTINES.    SUBDIVISIONS. 


General  attachment  and  mobility. 
Their  coats.    Peritoneal.    Extent;  attachment. 
Muscular:  Arrangement  of  layers;  order. 
Cellular:  Location;  different  names ;  why? 
Mucous:  General  properties;  epithelium, 
Valvulm  connwentes:  Nature,  extent. 
Villi:  Extent;  confined  to  small  intestines. 
Their  structure,  shape,  size;  number,  4,000,000. 
Lacteal:  Commencement,  destination,  use. 
Number,  variation — 4  to  10  millions ;  extent. 
Follicles  of  small  intestines ;  nature;  where. 
Number  estimated  as  high  as  35  millions. 
Duodenal  or  Brunner's  glands ;  where  found. 
Solitary,  or  glandulse  diffusa ;  where  ? 
Peyer's,  or  glandulse  aggregata;  where  ? 
Follicles  of  large  intestines;  numerous. 
Mesenteric  glands,  130  to  150.    Name. 
Shape,  size,  location,  structure,  use. 
Lacteal  vessels.    Location ,  structure,  use. 
Origin  and  termination,  like  lymphatics. 
Thoracic  duct;  relation  to  lymphatics. 
Location  of  receptaculum  chyli;  where  ? 

12 


STUDY  OF  INTESTINES,  Continued. 


Primary  division  into  small  and  large. 
Duodenum.    Its  shape;  direction  of  its  parts. 
Opening  of  ducts  into  it.    At  what  part  ? 
Its  structure  above  and  below  the  ducts. 
Valvulse  conniventes :  where  they  commence, 
Duodenal,  or  Brunner's  glands,  where  ? 
Villi,  in  what  part  of  duodennm  found  ? 
Jejunum.    Where  does  it  commence  ? 
Parts  found  within ;  general  arrangement. 
Its  length  and  changes  as  we  descend. 
Ileum.    Keason  of  the  name.    Where  ? 
Structures  found  in  the  intestines. 
Glandulae  aggregata,  or  Peyer's  glands. 
Their  general  arrangement — 20  to  30  patches. 
Valvulse  conniventes.    Arrangement.  Where  ? 
Their  distribution— from  600  to  800. 
Villi-    Their  structure  and  shape. 
Vessels  in  them.  Muscular  fibre.  Epithelium. 
Lacteal.    Their  origin  and  course. 
Their  final  destination  and  arrangement. 
Glands  which  their  fluid  must  pass. 
Square  inches  of  small  intestines,  1,400. 

13 


INTESTINAL  CANAL,  Continued. 


Total  length,  30  feet.     Not  uniform. 
Length  of  each  subdivision.    Repeat. 
Small  intestines  already  considered. 
Ccecum-    Its  relations  to  ileum  and  colon. 
Ilio-csecal  valve.    Its  structure  and  object. 
Appendix  vermiformis.  Location,  length,  size. 
Glandular  character  of  its  inner  surface.   Use. 
Colon.    Subdivisions.     Location  of  each. 
Peculiarities  of  the  sigmoid  flexure — what  ? 
Its  appearance.  Arrangement  of  muscular  coat. 
Structures  found  on  its  inner  surface — what  ? 
Total  surface  of  alimentary  canal,  2,000  s.  in. 
Stomach,  100  sq.  in.  for  vascular  absorption. 
Small  fntestines,  1,400  for  2  kinds  absorption. 
Large  intestines,  500,  for  vascular  absorption. 
Total,  2,000  sq.  in.  for  vascular  absorption. 
1,400  square  inches  for  lacteal  absorption. 
Trace  the  course  of  chyle  to  the  heart. 
Trace  material  absorbed  by  vessels  to  the  heart. 
Through  what  structures  does  each  pass  ? 
Clearly  distinguish  the  two  plans  of  absorption 

Also  the  two  routes  to  the  heart. 

14 


GLANDULAR  ORGANS. 


Liver.    Position.    Relation  to  diaphragm. 
Length,  10  to  12  inches.    Transverse  in  body. 
Breadth,  5  to  8  inches,  antero-posterior. 
Thickness,  1  to  3  inches.  Thickest  part,  where  ? 
Surfaces,  convex  and  concave.     Contact. 
Notches  in  borders,  where  ?    Appearance  ? 
Structures  covering  liver,  what  ?    Describe. 
Capsule  of  G-lisson,  where  ?    Nature  ? 
Ligaments,  5.    U.  F.  C  R.  L.    Use? 
Lobes,  5.    R.  L.  S.  C  Q.    Where  ? 
Fissures,  5.    U.  P.  G,b.  D,v.  V,c.    Show. 
Vessels,  5.    H,a.  P,v.  H,v.  H,d.    Lymphatics. 
Peculiarities  of  portal  vein.    Describe. 
Vessels  uniting  to  form  vena  porta,  what  ? 
Nerves  supplying  the  liver.    Source. 
Gallbladder.    Location;  size;  use. 
Its  structure.    Cystic  duct.    Hepatic  duct. 
Ductus  choledochus.    Length;  termination. 
Size  of  duct.    Biliary  calculi,  where  ? 
Channels  for  portal  blood  to  the  heart. 
General  purpose  of  portal  circulation. 

By  what  forces  is  portal  blood  moved  ? 

15 


GLANDULAR  ORGANS,  Continued. 


Speen.    Its  location  and  connections. 
Its  general  presence  in  the  animal  kingdom. 
Its  length,  breadth,  and  thickness,  5,  2,  1,  in. 
Its  weight,  4  to  8  oz.     15  to  20  ft>s.     Even  40. 
Its  investments,  its  trabeculae,  where  ? 
Its  vessels;  entrance  and  exit;  hilus. 
Destination  of  its  blood;  direction. 
Very  large  size  of  its  vessels;  inference. 
Great  elasticity  of  its  veins.    Use.    Dilate. 
Verves  supplied  to  the  spleen.     Source. 
Various  offices  assigned  to  the  spleen. 
Pancreas.     Location;  general  direction. 
Its  relation  to  the  duodenum;  its  head. 
Its  length,  width,  and  thickness,  6,  2, 1. 
Its  weight,  3  to  6  oz.  Little  prone  to  change. 
Duct.    Location,  size,  termination.    Where  ? 
Comglomerate  gland.  Abdom.  salivary  gland. 
Arteries  supplying  it;  source,  location. 
Veins;  location.    Destination  of  blood. 
Nerves ;  source :  how  supplied  to  it. 
General  presence  in  vertebrata. 
Remarkable  freedom  from  disease. 

16 


FUNCTIONS  TRIBUTARY  TO  DIGESTION. 


L  Prehension,  and  prehensile  apparatus. 

Mouth,  lips,  tongue,  suction  apparatus. 

Sucking  power  of  mammalia,  human. 

Hands  and  all  modifications  of  extremities. 

Hands  of  quadrumana:  differ  from  man. 

Forearm  and  hand  of  carnivora;  use. 

Rodentia:  handy  use  of  anter.  extremity. 

Proboscis  of  elephant,  40,000  muscles. 

Tongue  of  giraffe;  of  ant-eater;  of  ox. 

Birds:  long  bill,  numerous  modifications. 

Tongue  long,  barbed,  to  transfix  prey. 

Hyoid  apparatus,  for  protruding  tongue. 

Reptiles:  prehensile  jaws,  recurved  teeth. 

Orifice  for  receiving  food,  large.     Snake. 

Insects :  long,  flexible  tube.     Suctoria. 
IL  Mastication.    Where  performed. 

Muscles  oi  mastication  in  man,  what  ? 

Teeth;  their  uses  in  mastication. 

Their  adaptation  to  different  foods. 

Motion  of  jaws  in  different  animals. 

Articulation  of  jaw  to  this  end. 

Carnivorous  and  rodent  jaw  contrasted. 

2  17 


TRIBUTARY  FUNCTIONS,  Continued. 


III.  Insalivation.    Meaning  of  the  term. 
Sources  of  this  secretion  in  man. 
Salivary  glands.  Number;  name;  location. 
Their  general  presence  in  animals. 
Their  absence  in  fishes.    Reason  for  this. 
General  character  of  their  secretion. 
Importance  of  thorough  insalivation. 

IV.  Deglutition.    Apparatus  concerned. 
Passage  of  food  through  fauces.    Tongue. 
Relation  of  tonsils  to  food  passing. 
Pharynx,  its  extent  and  connections. 
Motions  of  soft  palate  in  deglutition. 
Upper  part  of  pharynx  closed  off.   How  g 
Agency  of  the  tongue  in  moving  food. 
Closure  of  the  glottis,  how  effected. 
Constrictor  muscles  of  pharynx;  action. 
What  part  of  act  of  deglutition  voluntary  ? 
Conditions  required  to  secure  the  act. 
Agency  of  glosso-pharyngeal  nerve  in  it. 
Action  of  oesophagus  in  deglutition. 
Passage  of  food  into  the  stomach. 
Structure  of  the  oesophagus.    Describe. 

18 


PERINEUM.    Parts  to  be  studied. 


Osseous  boundaries,  modified  by  ligaments. 
Greater  and  lesser  sacro-sciatic  notches. 
Greater  and  lesser  sacro-sciatic  ligaments. 
Division  into  triangles.    Boundaries. 
Anterior,  or  genito-urinary  triangle. 
Posterior,  rectal,  or  anal  triangle. 
Penis:  location;  parts  composing  it. 
Corpora  cavernosa.     Crura.    Attachment. 
Their  structure.     Septum  pectiniforme. 
Corpus  spongiosum  urethra — where  ? 
Prepuce.     Glans  penis-    Corona  glandis. 
Adherent  prepuce.     Cause  of  trouble. 
Xeck.     Structure  covering  glans,  frenum. 
Glandular  apparatus.     Secretion. 
Meatus  urinarius.     Size,  shape. 
Fossa  navicularis.     Size,  shape. 
Urethra.    How  enclosed,  relative  size,  bulb. 
Spongy,  membranous,  and  prostatic  portions. 
Structure:  muscular,  fibrous,  mucous. 
Arteries  of  penis — from  what  source  derived. 
Veins;  location  and  termination. 
Nerves;  their  source  and  distribution. 

19 


DISSECTION  OF  PERINEUM. 


Anterior  triangle;  parts  within  it. 
Superficial  fascia,  its  connections — where  ? 
Superficial  perineal  fascia — where  ? 
Muscles  covered  by  it.    Its  relations  to  them. 
Accelerator  urinse;  location,  O.  I.  action. 
Erector  penis ;  erector  clitoridis-    Where  ? 
Transversalis  perinei;  irregularity;  0. 1,  ac. 
Bulb  of  urethra.    How  covered,  shape. 
Arteries  of  the  region;  origin,  distribution. 
Veins  of  the  region ;  their  distribution. 
Deep  perineal  fascia;  triangular  ligament. 
Opening  for  passage  of  urethra — where  ? 

Posterior  triangle. 
Superficial  sphincler  ani;  location. 
Arrangement  of  fibres;  origin,  insertion. 
Internal  sphincter  ani;  nature,  extent. 
Its  location,  its  width,  action. 
Structure  of  the  two  sphincters.    Use. 
Ischio-rectal  fossa;  structures  occupying  it. 
Levator  ani;  its  shape,  origin,  insertion,  use. 
Arteries :  their  source  and  distsibution. 
Veins:  peculiarities,  termination. 

20 


SCROTUM,  TESTES,  Etc, 


1.  Skin;  its  character,  raphe,  hairs. 

2.  Dartos;  its  position,  natnre,  nse. 

3.  Inter-columnar  or  spermatic  fascia. 

4.  Cremasteric  fascia;  its  nature,  use. 

5.  Fascia  propria  of  cord;  whence  derived. 

6.  Tunica  vaginalis  reflexa ;  nature. 

7.  Tunica  vaginalis  propria,  where  ? 

8.  Tunica  albuginea;  mediastinum  testis. 

9.  Tunica  vasculosa;  pia  mater  testis. 
Of  proper  gland  structure  and  ducts. 

1.  Tubili  seminiferi,  ik  of  inch  in  diameter. 

2.  Lobuli  testis,  300x16  feet—  Monroe. 

3.  Vasa  recta,  20  to  30,  sV  of  inch  in  diameter. 

4.  Rete  testis — where  situated,  nature. 

5.  Vasa  efferentia,  15  to  20,  where  located. 

6.  Coni  vasculosi,  15  to  20,  6  inches  long. 

7.  Globus  major  and  globus  minor,  what  ? 

8.  Epididymis,  "location,  20  feet — doubt. 

9.  Yas  deferens,  structure;  -h  of  an  inch. 
Course  to  termination,  2  feet — where  ? 
Vesiculse  seminales;  ejaculatory  duct. 
Course  and  termination  of  duct. 

21 


URINARY  ORGANS. 


Kidneys,  4  inches  long,  3  wide,  1  thick. 
Location,  investment,  color,  shape. 
Snpra  renal  capsnles,  location,  shape. 
Size  at  different  ages.     Supposed  nse. 
Hilus  of  kidney,  location,  shape,  use. 
Vessels  of  kidney,  artery,  arrangement. 
Vein,  termination,  quality  of  blood. 
Ureter,  location,  size,  termination,  use. 
Coats  of  this  canal — muscular,  fibrous,  mucous. 
Pelvis  of  kidney — shape,  structure,  location. 
Infundibuli — number,  nature,  where  ? 
Calix,  papillae,  Malphigian  pyramids. 
Cortical  and  medullary  portion,  where  ? 
Tubuli  uriniferi :  arrangement,  termination. 
Malphigian  bodies  or  corpuscles,  where  ? 
Arrangement  of  vessels  in  these  bodies. 
Arrangement  of  veins  among  tubuli  uriniferi. 
Cells  lining  the  tubuli  uriniferi — use. 
An  immense  secreting  or  eliminating  surface. 
Termination  of  ureters  in  bladder,  where  % 
Oblique  or  valvular  mode  of  opening. 
Size  of  orifice  in  bladder.    Results. 

22 


BLADDER  AXD  ASSOCIATED  PARTS. 


Its  location  and  shape,  vary  with  age. 
Fundus,  body,  base,  location  of  each. 
Peritoneal  covering :  where  and  how  nmch  ? 
Muscular  coat:  arrangement  of  layers. 
External,  detrusor  urinaB;  plan. 
Circular,  irregular,  oblique  vary. 
Sphincter  vesicae:  structure,  location. 
Influence  of  elastic  tissue  in  sphincter. 
How  is  the  orifice  of  the  urethra  opened  ? 
Closed  by  reflex  nervous  influence. 
Prostate  gland:  general  shape  and  location. 
Structure  of  prostate,  largely  muscular. 
Its  glandular  element,  follicular  pouches. 
Prostatic  sinus:  openings  into  sinus. 
Sinus  p ocularis:  location,  size,  direction. 
Yeru  montanum  or  caput  gallinaginis. 
Uterus  masculinus'.  reason  for  the  name. 
Ejaculatory  ducts  opening  near  it. 
Homology  of  this  arrangement,  trace. 
Lobes  of  prostate  gland;  number. 
Views  concerning  the  third  lobe. 
Its  great  pathological  importance. 

23 


DISSECTION  OF  HEAD  AND  FACE. 


1.  Muscles  above  the  orbit : 

Occipito,  frontalis;  location,  O.  I.  action. 

Pyramidalis  nasi;  formation,  action. 

Orbicularis  palpebrarum,.  0. 1,  action. 

Corrugator  supercilii;  location,  O.  I.  ac. 
II.  Muccles  between  orbit  and  mouth. 

Orbicularis  palpebrarum,  location. 

Levator  labii  sup.  et  alse  nasi,  location. 

Levator  labii  sup.  proprius,  connections. 

Levater  anguli  oris,  location,  direction. 

Zygomaticus  major  and  minor,  where  ? 

Depressor  labii  superioris,  its  location. 

Orbicularis  oris  and  buccinator,  where  ? 
III.  Muscles  between  mouth  and  chin : 

Orbicularis  oris  and  buccinator,  extent. 

Depressor  anguli  oris,  shape,  location. 

Depressor  lab.  inferioris,  and  lev.  lab.  inf. 

Vessels,  artery,  branches  &  anastomoses. 

Vein,  commences,  ends,  location  on  face. 

Nerves,  facial,  where  distributed — use. 

Trifacial,  its  three  places  of  exit  on  face. 

Distribution  and  power  imparted  by  it. 
24 


DISSECTION  OF  NECK. 


Boundaries  of  quadrilateral — what  ? 
Division  into  primary  triangles — how  ? 
Important  operations  performed  in  neck. 
In  medium  line,  Laryngotomy,  Tracheotomy. 
In  carotid  triangle,  ligature  of  arteries. 
In  subclavian  triangle,  in  occipital  triangle. 
Parts  to  be  displayed  by  dissection, landmarks. 
Removal  of  integument.    Elasticity.     Utility. 
Superficial  fascia,  nature,  extent,  connections. 
Platysma-myoid  muscle;  its  character,  extent 
Its  relation  to  deep  structures,  attachments. 
External  jugular  vein;  commence,  terminate. 
Anterior  jugular  vein;  location,  irregular. 
Deep  cervical  fascia;  nature,  extent,  covers. 
Sterno-cleido-mastoid  muscle;  its  description. 
Relation  of  its  deep  surface,  and  its  borders, 
Parts  concealed  by  it.  What  overlapped  by  it. 
Omo-hyoid  muscle;  origin,  direction;  etc. 

Obliquely        (  Platysma  myoid — action. 
Ascending      I  Sterno-cleido-mastoid — action. 
Group  of  M.  (  Omo-hyoid — action. 

25 


DISSECTION  OF  NECK,  Continued. 


Salivary  glands.    Three,  relative  size. 
Parotid;  location,  reason  of  the  name. 
What  structures  cover  the  gland;  thick 
Its  extent,  superiorly,  and  inferiorly,  where  ? 
Its  extent  anteriorly  and  posteriorly,  where  ? 
Relation  of  its  deep  parts,  with  what  ? 
Effect  upon  the  gland  by  opening  mouth. 
Excretory  duct  of  gland;  begin  and  end. 
Its  structure,  and  location  on  the  face;  rule. 
Vessels  entering  and  leaving  the  gland  below. 
Vessels  entering  and  leaving  it  above,  where  ? 
Structures  leaving  it  in  front;  what  ? 
JVerves  associated  with  this  gland. 
Facial  ;  its  exit  from  the  cranium ;  where  ? 
Its  arrangement  in  the  gland — plexus. 
Branches  from  it,  what  and  where.    Direction. 
Muscles  supplied  by  this  nerve.     Location. 
Auricularis  magnus  nerve  joining;  where  ? 
Relation  of  Facial  and  Trifacial  nerves. 
What  is  the  real  seat  of  Neuralgia  ? 
Lymphatic  glands  in  parotid  region. 
Diseased  lymphatic  and  parotid  confounded. 

26 


DISSECTION  OF  NECK,  Continued. 


Directly  j  Sternohyoid. 

Ascending     ■<  Sterno-thyroid. 
Gronp  of  M.  (  Thyro-hyoid. 

Origin,  insertion  and  action  of  each  one. 
Their  relation  to  each  other.     Shape,  ribbon. 
Parts  or  organs  lying  beneath  them. 
Operations  made  between  them,  where  ? 
Laryngotomy.      Where  made.    What  divided. 
Crico-thyroid  space,  membrane.    Thickness. 
Vessels  found  on  the  membrane,  what  ? 
Its  source  distinction,  danger  of  irregularity. 
Tracheotomy  ;  parts  involved  in  the  operation. 
In  what  part  of  trachea  ?    What  decides  ? 
Parts  covering  trachea  in  front;  depth;  fascia. 
Thyroid  gland ;  of  what  parts  composed. 
Its  location,  connection,  size  of  different  parts. 
Arteries  supplying  the  gland;  their  source. 
Veins  from  it;  location,  place  of  termination. 
Direction  of  trachea;  size,  appearance. 
CEsophagotomy ;  where  made,  dangers. 
Parts  requiring  attention.    What  to  avoid. 
Reasons  for  selecting  the  left  side. 

27 


DISSECTION  OF  NECK,  Continued. 


Change  in  location  of  parts  by  stretching. 
Submaxillary  triangle;  boundaries. 
Digastric  muscle;  location,  origin,  insertion. 
Direction  of  its  bellies:  shape  of  each,  action. 
Submaxillary  gland:  shape,  size,  vessels. 
Parts  covering  the  gland;  lymphatic  glands. 
Its  excretory  duct.    Wharton,  termination. 

Supra-Hyoid 


Mylohyoid. 
Genio-hyoid. 
Genio-hyo-glossus. 
Four.        [Hyo-glossus. 


group 
of  muscles 


Mylo-hyoid:  shape,  location,  action,  use. 
Forms  floor  of  mouth,  attachments.    Where  ? 
G-enio-hyoid :  origin,insertion, direction, action. 
Genio-hyo-glossus:  shape,action  of  diff.  parts. 
Hyo-glossus:  location,  size,  action. 
Branches  of  external  carotid  artery :  where  ? 
Superior  thyroid:  location,  direction,  branches 
Lingual:  origin,  direction,  branches. 
Facial:  origin,  course  below  the  jaw. 
Its  relation  to  submaxillary  gland. 
Branches  in  neck:  variation  in  origin. 

28 


MUSCLES  OF  MASTICATION,  ETC. 


Masseter,  size,  shape,  how  covered,  O.  I.  A. 

Temporal :  relation  to  temporal  fascia,  0.  L  A. 
Internal  pterygoid,  origin,  direction,  action. 

External  pterygoid,  origin,  direction,  action. 

Nerve  supplying  these  muscles ;  source. 

Muscle  at  upper  part  of  neck;  where. 

Obliquely  f  Digastric, 

descending  !  Stylo-hyoid. 

group,  ]  Stylo -glossus- 

Four.  ^Stylo-pharyngeus. 

Digastric,  direction  of  bellies  and  tendon. 
8tylo-7iyoid)  direction;  how  pierced. 
Stylo-glossus,  its  action  on  the  tongue. 
Stylo-pharyngeus,  relation  to  constrictors. 
Nerves  displayed  in  this  dissection. 
Hypo. glossal,  exit,  direction,  distribution, 
Descendens  noni,  name,  distribution,  use. 
Glossopharyngeal,  direction,  distribution. 
Occipital-artery,  origin,  direction, distribution. 
Posterior  auricular,  distribution,  size. 
Internal  carotid  artery;  course  up  the  neck. 
Its  relation  to  internal  jugular  vein. 

29 


MOUTH  AND  ASSOCIATED  PARTS. 


Mouth:  Its  boundaries,  lining  membrane. 
Soft  palate;  structure,  attachments. 
Muscles  associated  with  it,  and  how. 
Palato-glossus:  palato-pharyngeous;  size. 
Levator  palati:  circumflexus,  or  tensor  palrti, 
Fauces:  location,  boundaries,  extent. 
Parts  circumscribing  fauces.    Tonsils,  size. 
Pharynx:  extent,  shape  of  cavity,  location. 
Openings  into  pharynx:  posterior  nares. 
Eustachian  tube:  size,  direction  of  passage. 
Openings  from  pharynx:  glottis,  where? 
Its  communication  with  (Esophagus. 
Structure  of  pharynx:  muscles,  number. 
Constrictors:  stylo-pharyngeous; pal.-pharyn. 
Vessels:  their  source,  size,  carotid  artery  ? 
Nerves:  whence  derived,  special  use. 
Pharyngeal  glands :  location,  use. 
Tongue:  muscles  associated  with  it. 
Palato-glossus;  stylo -glossus;  hyo-glossus. 
Genio-hyo-glossus :  lingualis;  shape. 
Nerves  supplied  to  the  tongue:  what  % 
Papillae  of  tongue;  three  varieties. 

30 


APPENDAGES  OF  THE  EYE. 


Eye-lids:  internal  and  external  canthus. 
Tarsal  cartilages :  shape,location, attachments. 
Cilia:  their  location,  use;  prominent  bulb. 
Meibomian  glands:  location,  shape,  use. 
Conjunctiva:  nature,  extent,  connections. 
Plica  semilunarics :  caruncula  lachrymalis. 
Lachrymal  apparatus:  general  purpose. 
Lachrymal  gland:  shape,  size,  location. 
Lachrymal  ducts :  place  of  opening;  number. 
Lachrymal  papillae :  location,size,appearance. 
Lachrymal  canals :  open.,direction,termination 
Lachrymal  sac:  location,  shape,  size,  bones. 
Nasal  duct:  direction,  size,  termination. 
Muscles  within  the  orbit  eight,  outside,  one. 
Muscles  acting  on  the  eyelids :  two ;  name. 
Muscles  acting  on  the  eye-ball :  six ;  name. 
Recti:  general  arrangement;  action  of  each. 
Oblique:  their  arrangement  and  action. 
Arteries  within  the  orbit:  origin,  distribution. 
Nerves  to  the  orbit;  how  many  pairs. 
Motor  oculi:  muscles  supplied  by  it. 
Fourth  and  sixth  nerve:  muscles  supplied. 

31 


DISSECTION  OF  EYE-BALL 


Its  form  and  general  division. 
Sclerotic  coat;  location,  structure,  use. 
Cornea;  structure,  union  with  sclerotic. 
Choroid;  its  location  and  connections. 
Its  external  layer— venae  vorticosse. 
Its  middle  layer — tunica  Ruyschiana. 
Its  internal  or  pigmentary  layer — use. 
Ciliary  ligament,  and  ciliary  processes. 
Retina;  location,  formation,  termination. 
Its  external  layer,  or  Jacob's  membrane. 
Its  middle,  granular,  nummular. 
Its  internal  or  nervous  layer,  contact. 
Membrana  limitans,  what  and  where  ? 
Arteria  centralia  retinae,  arrangement. 
Chambers  of  the  eye,  how  occupied. 
Anterior  and  posterior,  how  connected. 
Iris;  location,  structure,  object,  action. 
Crystalline  lens ;  location,  structure,  use. 
Capsule  of  lens;  its  connection,  structure. 
Vitreous  humor,  or  vitreous  body,  where  ? 
Vessels  to  the  eye-ball,  their  source. 
Nerves  supplying  iris,  their  source. 

32 


THORAX  AND  CONTENTS. 


First,  the  study  of  their  location. 
Mode  of  opening  thorax  to  secure  views. 
Boundaries  of  thorax:  in  what  manner. 
Superiorly:  first  rib  and  fascia;  shape. 
Inferiorly  diaphragm:  shape;  structure. 
Posteriorly:  vertebrae  and  ribs ;  shape. 
Laterally:  ribs  and  intercostal  muscles. 
Anteriorly:  sternum  and  costal  cartilages. 
Depth  of  thorax:  anteriorly,  laterally,  poste. 
Division:  pleural  cavities ;  mediastinum. 
Reflections  of  pleura:  space  between. 
What  immediately  behind  the  sternum  ? 
Position  of  heart:  base,  apex.;  where  ? 
Its  relation  to  median  line  of  body:  show. 
Projection  from  median  line,  each  side. 
Where  does  the  apex  of  the  heart  present  ? 
What  is  between  the  sternum  and  heart  ? 
Relation  of  lung  to  the  heart;  inflate. 
Structures  in  thorax  above  the  heart. 
Thymus  gland  in  foetal  life;  where  ? 
Appearance  of  vessels  there  exposed  % 
Membrane  enveloping  the  heart;  inflate. 

3  33 


RESPIRATORY  APPARATUS. 


Trachea:  commencement;  termination. 
Its  structure :  rings ;  their  investment. 
Where  incomplete:  structure  uniting  them. 
Bronchial  tubes :  length,  direction,  size. 
Structure  throughout  the  lungs;  purpose. 
Cartilage:  plan  of  arrangement;  use. 
Muscular  structure:  agency  in  respiration. 
Mucous  membrane:  ciliated  epithelium. 
Lungs:  lobes  in  each;  division;  pleura. 
Their  general  shape;  apex,  base,  edge. 
Lobules:  number  of  cells  in  each. 
Estimated  number  of  air  cells;  size. 
Estimated  surface  for  respiration;  vary. 
Arrangement  of  capillaries :  where  ? 
Parenchyma  of  lungs:  elasticity. 
Blood-vessels  to  nourish  lungs :  source. 
Pulmonary  artery,  and  pulmonary  veins. 
Nerves:  pneumogastric,  pulmonary  plexus. 
Persistent  air;  Residual  air  100  C.  I. 
Supplemental  air,  100;  Tidal  air,  25. 
Complemental  air,  100  cubic  inches. 
Thickness  of  membrane  between  air  &  blood. 

34 


CHANNELS  FOR  CIRCULATING  FLUIDS. 


1,  Arteries;  2,  veins;  3,  capil.;  4,  lyrnp.;  5,  lac. 

1.  Arteries :  reason  of  the  name;  old  views. 
Their  general  character  and  nses:  action. 
Direction  of  the  circulation,  forces. 

2.  Veins:  structure  compared  with  arteries. 
Direction  of  the  blood  current. 
Yalves:  formation  and  uses. 

Arteries  and  veins:  relative  capacity. 

3.  Capillaries  :  general  character. 
Their  size,  length,  arrangement. 
Their  function  in  regard  to  tissues. 

4.  Lymphatics:  peculiarities;  where. 
Their  general  structure;  valves. 
Material  circulated;  its  source. 

5.  Lacteals:  where  found;  appearance. 
Commencement;  mode  of  origin. 
Destination  of  the  fluid  they  contain. 
All  these  channels  closed  tubes. 
How  do  fluids  enter  and  leave  ? 
Forces  that  move  the  fluids. 
Ceaseless  motion  of  circulating  fluids. 

Do  blood  discs  pass  through  walls  of  vessels, 

35 


CIRCULATORY  APPARATUS. 


Heart:  central  organs;  location. 
Its  general  shape  when  distended. 
Primary  division :  right  and  left. 
The  pulmonic  and  systemic  heart. 
Reason  of  name:  respective  use. 
Division  into  anricle  and  ventricle. 
No  communication  between  sides. 
General  nse  of  each  cavity  of  heart. 
Harmonious  action  of  right  and  left. 
Course  of  blood  through  the  heart. 
Right  auricle:  location  at  base  of  heart. 
Its  general  shape  and  appearance. 
Appendix  auriculse:  where  situated. 
Vessels  opening  into  right  auricle. 
Superior  vena  cava:  where  seen. 
Inferior  vena  cava:  place  of  opening. 
Coronary  sinus:  where  situated. 
How  formed;  source  of  its  blood. 
Coronary  valve:  its  location  and  use. 
Foramina  thebesii:  what  are  they  ? 
Musculi  pectinati:  what?  where? 
Tuburculum  Loweri :  where  seen;  use. 

36 


RIGHT  SIDE  OF  HEART,  Continued. 


Fossa  ovalis:  where  is  it  situated  ? 
How  caused  and  what  does  it  show  ? 
Annulus  ovalis:  its  appearance. 
Where  does  foramen  ovale  exist  ? 
When  and  in  what  manner  closed  ? 
Eustachian  valve:  where  and  why  ? 
Opening  from  right  auricle :  where  ? 
Ostium  venosum:  size;  appearance. 
Tricuspid  valve:  its  appearance. 
What  is  seen  within  right  ventricle  ? 
Columnse  carnese:  their  appearance;  use. 
Chordae  tendinese :  their  attachment. 
Closure  of  the  valve:  how  and  where  \ 
Opening  from  right  ventricle:  where  ? 
Conus  arteriosus :  what  and  where  ? 
Pulmonary  artery:  origin,  direction. 
Its  length;  division,  direction  of  each. 
Valve  at  its  commencement;  name. 
Shape  of  semilunar  valve:  closure. 
Sinus  of  Valsalva:  where  ?  appearance. 
Corpuscle  of  Arantius :  where  ?  use. 
Show  action  of  valves  with  blow-pipe. 

37 


HEART,  Continued.    LEFT  SIDE. 


Left  auricle;  its  position. 

Vessels  opening  into  it;  number. 

General  plan  of  arrangement,  show. 

How  can  the  left  auricle  be  seen  ? 

What  between  left  and  right  auricle  in  front  ? 

What  between  the  two  posteriorly  ? 

Where  do  the  pulmonary  veins  originate? 

Peculiarities  of  pulmonary  veins. 

Opening  from  left  auricle,  where  •? 

Valve  closing  the  opening;  name. 

Resemblance  to  what  other  one  ? 

Name  the  parts  associated  with  it. 

What  is  the  size  of  the  ostium  arteriosum  ? 

Course  of  blood  from  ventricle. 

Location  of  aorta:  where  ?  size  ? 

What  valve  at  its  commencement  ? 

Sinus  of  Valsalva:  what  ?  where  ? 

Corpuscle  of  Arantius;  their  use. 

Columnse  carnese :  where  ?  use  ? 

Lining  membrane  of  ventricle. 

Septum  ventriculorum,  plan. 

Illustrate  action  of  valves  by  blow-pipe. 

38 


REGION  OF  FEMORAL  HERNIA. 


Its  proximity  to  inguinal  hernia. 
Sex  most  common — why  ?    Diagnosis. 
Superficial  fascia:  nature,  extent;  where? 
Superficial  vessels:  what  ?  where  ?  size  ? 
Inguinal  glands:  location,  number. 
Fascia  lata :  extent,  attachments ;  illustrate. 
Iliac  and  pubic  portions:  why  ?  where  ? 
Saphenous  opening:  size,  shape,  location. 
Falciform  border :  attachments,  tension. 
Cribriform  fascia :  its  nature ;  where  ? 
Crural  arch:  how  formed,  shape,  size. 
Structures  passing  beneath  it — where  ? 
Their  relative  position;  weak  point. 
Femoral  canal ;  what  and  where  is  it  ? 
Femoral  sheath:  how  formed,  nature. 
Femoral  ring:  location,  boundaries,  size. 
Its  crural  septum:  what  and  how  formed. 
Seat  of  stricture  in  hernia;  position  to  relax* 
Obturator  artery:  usual  place;  irregular. 
Coverings  of  hernial  tumor  in  order. 
1,  skin;  2,  sup.  fascia;  3,  cribriform;  4,  sheath 
of  vessels :  5  septum  crurale,  6  peritoneum. 

39 


ANTERIOR  FEMORAL  REGION. 


What  to  study.     Surgical  landmarks. 
Superficial  fascia:  its  character. 
Inguinal  glands :  their  location. 
Superficial  vessels  of  the  region,  what  ? 
Arteries:  number,  names,  destination. 
Veins:  source,  location,  destination. 
Fascia  lata:  attachments,  extent. 
Its  ganeral  character,  subdivisions. 
Scarpa's  triangle:  its  boundaries. 
Parts  contained  within  it;  covered. 
Structures  passing  under  Poup art's  ligament. 
Femoral  vein:  location,  change  of  relation. 
Femoral  artery  :  branches  arising  from  it. 
Origin  of  profunda-femoris,  where  ? 
Its  location  and  principal  branches. 
Circumflex  and  perforating,  where  ? 
Anterior  crural  nerve:  location. 
Its  formation  and  distribution;  branches. 
Artery  in  middle  of  the  thigh;  where  ? 
Muscle  covering  it,  how  arranged. 
Where  does  artery  disappear  from  front  ? 
Hunter's  canal :  where  ?  formation  ?  use  ? 

40 


MUSCLES  ON  FRONT  OF  THIGH. 


I.  Superficial  Group.  Three  muscles. 

1.  Tensor  vaginse  femoris :  location,  use. 

Its  relations  to  fascia  lata,  origin,  insertion. 
Fascia  lata:  relations  to  thigh;  to  knee. 
Thick,  thin,  reflexions,  attachments. 

2.  Sartorius:  length,  location,  coverings. 
Change  of  relation  in  descending;  O.  I.  A. 

3.  Gracilis:  location,  shape,  origin,  insertion. 
Its  relation  to  adductor  group  of  muscles. 

II.  Group  of  muscles.  Adductors.  Four. 

1.  Pectineus:  location,  shape,  direction;  O.I.A. 
Structures  lying  on  and  passing  over  it. 

2.  Adductor  longus :  gen.  shape,  posit.,  O.I.A. 
Its  relation  to  other  adductors ;  tendon. 

3.  Adductor  brevis:  its  position,  0.  I.  action. 
Nerves  and  vessels  passing  over  it. 

4.  Adductor  magnus:  relative  size;  where  ? 
Parts  in  contact  and  perforating  it. 
General  blending  of  adductor  group. 
Vessels  perforating  these — where  ?  what  ? 
Nerves  supplying  these  muscles. 

Have  these  muscles  more  than  one  action  ? 

41 


FRONT  OF  THIGH,  Continued. 


III.  Flexor  muscles  of  thigh:  three. 

1.  Psoas  parvus:  location,  irregularity. 
Reasons  for  placing  in  this  group. 

2.  Psoas  magnus:  location,  covering,  O.I. A. 
Relation  to  lumbar  plexus  of  nerves. 
Place  and  mode  of  blending  with  iliacus. 

3.  Iliacus  internus :  location,  shape,  O.I.  A. 
Its  relations  to  capsular  ligament. 

A  bursa  beneath;  its  relation  to  hip  joint. 
Union  with  psoas;  direction  to  insertion. 
Anterior  crural  nerve :  location,formation. 
Branches  of  distribution;  gen.  direction. 
Branches  of  femoral  artery;  their  course. 

IV.  Muscles  on  front  of  thigh — four. 
Rectus  femoris:  location,  shape,  O.  I.  A. 
Vastus  internus:  shape,  location,  0. 1.  A. 
Vastus  externus:  size,  location,  O.  I.  A. 
Crureas:  its  relation  to  the  vasti  muscles. 
Its  relation  to  femur,  blending,  O.  I.  A. 
Relation  of  these  four  to  knee  joint. 
Relations  to  patella;  they  envelop  femur. 
Vascular  supply — whence  derived  ? 

42 


DISSECTION  OF  GLUTEAL  REGION. 


1.  Group  of  thigh  extensors — three. 
Gluteus  niaximus:  location,  shape. 
Arrangement  and  direction  of  fibres,  O.I.  A. 
Its  relations  to  trochanter  major;  bursa. 
Its  relations  to  fascia  lata;  aponeurosis. 

2.  Gluteus  medius:  shape,  location,  O.  I.  A. 
Direction  of  fibres  of  anterior  portion;  use. 

3.  Gluteus  minimus:  location,  shape,  O.  I.  A. 
Secondary  action  of  glutei  muscles,  as 
Abductors,  and  internal  rotators.    Show. 
What  portion  can  cause  the  latter  motion  ? 
What  muscles  perform  abduction  ?    Illust. 

II.  External  rotator  group — six. 

1.  Pyriformis  :  its  location,  direction,  action. 

2.  Gemellus  superior:  origin,  insertion,  direc. 

3.  Obturator  internus:  location,  shape,  O.I.A. 

4.  Gemellus  inferior  :  relation  to  obturator. 

5.  Obturator  externus:  location,  how  exhibit. 

6.  Quadratus  femoris:  location,  shape,  action, 
xirteries  of  this  region,  source,  distribution. 
Nerves :  greater  and  lesser  sciatic,  where  ? 
Place  of  exit  from  the  pelvis;  formation.  ? 

43 


POSTERIOR  PART  OF  THIGH. 


I.  Flexor  muscles  of  the  leg — four. 

1.  Semitendinosus;  shape,  location,  0.  I.  A.  ? 

2.  Semimembranosus;  arr.  of  tendon  O.  I.  A. 

3.  Biceps  flexor  cruris ;  relation  to  others  O.I. A. 

4.  Popliteus;  its  location,  peculiarity  0.  I.  A. 
Which  are  the  hamstring  muscles  ? 
Boundaries  of  the  popliteal  space;  shape. 
Structures  passing  behind  the  knee;  what  ? 
Popliteal  nerve;  whence  derived,  where  ? 
Popliteal  vein;  where  located  ?  size. 
Popliteal  artery;  location,  depth,  size. 

Its  relation  to  the  bone  in  the  space. 

Branches  of  the  popliteal  artery;  what  ? 

Relation  of  the  artery  to  gastrocnemius,  M. 

Relation  of  popliteal  nerve  to  the  same,  M. 

Peroneal  nerve ;  whence  derived  ?  location. 

Its  important  surgical  relation;  where  ? 

Yein  empty,  into  popliteal;  whence  ?  name. 

Course  of  great  sciatic  nerve  from  pelvis. 

Branches  supplied  in  the  thigh. 

Arteries  supplying  posterior  of  thigh;  what? 

Anastomoses,  ligature  of  popliteal. 

44 


DISSECTION  OF  LEG. 


«  Posterior  view,  superficial  landmarks. 
Superficial  vein,  external  saphenous. 
Commencement,  course,  termination. 
Internal  saphenous  vein;  location. 
External  saphenous  nerve;  location. 
Other  cutaneous  nerves ;  their  source. 
I.  Superficial  group  of  muscles — three. 

1.  Gastrocnemius;  location,  shape,  O.  I.  A. 
Vessels  and  nerves  supplying  it;  source. 

2.  Plantaris:  location,  its  irregularity,  O.  I.  A. 

3.  Soleus:  its  location,  size,  shape,  0.  I.  A. 
Union  to  form  tendo-Achilles ;  where  ? 
Vessels  and  nerves  beneath  the  soleus. 
Posterior  tibial  artery;   location,  branches. 
Position  on  lower  half  of  the  leg;  where  ? 
Posterior  tibial  nerve;  destination. 
Arteries  from  popliteal;  distribution. 
Structures  on  the  bottom  of  the  foot. 
Plantar  fascia;  its  attachments. 
Arrangements  of  its  three  portions. 

Its  relation  to  the  first  group  of  muscles. 
What  vessels  are  superficial  to  fascia. 

45 


DISSECTION  OF  LEG.    Front. 


I.  Anterior  tibial  group  of  muscles — three. 
Fascia  covering  the  muscles  in  front. 
Anterior  annular  ligament  and  its  use. 
Its  formation  and  attachments ;  strength. 

1.  Tibialis  anticus;  its  location,  extent. 

2.  Extensor  longus  pollicis;  its  relation. 

3.  Extensor  digitorum  communis ;  where  ? 
Dissection  and  description  of  each. 
Artery  in  front  of  the  leg;  its  source. 
Branches  of  anterior  tibial ;  where  ? 
Its  origin  and  course  to  the  foot. 

Its  branches  on  the  dorsum  of  the  foot. 
Where  and  with  what  does  it  anastomose  ? 
Nerves  on  the  front  of  the  leg;  source. 
Internal  saphenous;  source,  distribution. 
Musculocutaneous ;  source,  distribution. 
Anterior  tibial;  its  course  to  termination. 
Muscle  on  the  dorsum  of  the  foot. 
Extensor  brevis  digitorum;  O.  I.  action. 
Tendons  between  the  malleoli  in  front. 
Their  number,  order  and  destination. 
Relation  of  artery  to  these  tendons. 

46 


DISSECTION  LEG.    Posterior  Deep, 


I.  Posterior  group  of  muscles — three. 

1.  Tibialis  posticus;  location,  direction. 

2.  Flexor  longus  pollicis;  location,  direction, 

3.  Flexor  longus  digitorum;  destination. 
Dissection  and  description  of  each. 
Exchange  of  tendons  in  the  foot. 
Posterior  tibial  artery;  commencement. 
Its  branches;  peroneal,  distribution. 
Its  location  and  direction  the  on  leg. 
Its  position  near  malleolus;  where  ? 
Posterior  tibial  nerve;  begins  where  ? 
Its  course  down  the  leg;  branches. 

Its  position  at  the  ankle;  where  ? 
II.  Superficial  group  of  muscles  on  the  foot. 

1.  Abductor  pollicis;  appearance. 

2.  Flexor  brevis  digitorum ;  where  ? 

3.  Abductor  minimi  digiti;  where? 
Dissection  and  removal;  parts  exposed. 
Vessels  and  nerves  under  this  group. 
Plantar  artery;  arrangement,  branches. 
Plantar  nerve;  location,  destination. 

Arrangement  of  tendons  in  the  foot. 

47 


DISSECTION  LEG  AND  FOOT. 


I.  Peroneal  group  of  muscles --three. 

1.  Peroneus  longus :  location,  direction. 

2.  Peroneus  brevis:  location,  length. 

3.  Peroneus  tertius :  location,  blending. 
Dissection  and  description  of  each. 
Arrangement  of  tendons  at  the  ankle. 

I.  Between  the  malleoli  in  front:  four. 

I.  Tibialis  anticus;  2.  extensor  longus  pollicis. 
3.  Exten.  long,  digitorum;  4.  peroneus  tertius. 

II.  Behind  the  inner  malleolus;  three. 

1.  Tib.  post.2.  Flex.  long. dig.  3.  Flex.long.pol. 

III.  Behind  the  external  malleolus;  two. 
1.  Peroneus  longus;  2.  Peroneus  brevis. 
IY.  Between  the  malleoli,  behind;  one. 

Tendo  Achilles:  three  muscles  united. 
Second  layer  of  muscles  on  the  foot;  five. 
Musculus  accessorius  and  4  lumbricales. 
Third  layer  of  muscles  on  sole  of  foot;  four. 
1.  Flex,  brevis  pollicis;  2.  Adductor  pollicis. 
3.  Flex.  brev.  min.  dig. ;  4.  Transversalis  pedis. 
Plantar  interossii,  between  bones,  three. 
Dorsal  interosii,  between  metacarp  .bones,  four. 


DISSECTION  OF  UPPER  EXTREMITY. 


Dissection  of  shoulder  and  axilla. 
Pectoralis  major  muscle:  location,  shape. 
Structures  covering  the  muscle;  gland. 
Origin;  direction  of  different  parts. 
Insertion;  its  relation  to  deltoid,  vein. 
What  structures  does  this  muscle  conceal  ? 
Its  relation  to  axillary  border;  shaDe  there. 
Vessels  and  nerves  in  front  of  shoulder. 
Pectoralis  minor:  location,  shape,  direction. 
Boundaries  of  axilla:  its  depth,  shape. 
Parts  to  be  studied  in  the  axilla. 
Axillary  glands:  location,  number,  10  to  12. 
Course  and  termination  of  lymphatics. 
Connective  tissue  of  the  axilla;  nature. 
Axillary  vein :  formation,  location,  ending. 
Axillary  artery:  commencement,  location. 
Branches  arising  from  it — what  ?  where  ? 
Distribution  of  these  branches ;  size. 
Nerves  found  in  the  axilla — where  ? 
Axillary  plexus :  how  formed,  size. 
Nerves  forming  it,  5th,  6th,  7th,  &  8th,  &  1st  d. 
Nerves  given  off  from  the  plexus. 
4  49 


DISSECTION  OF  BACK  AND  SHOULDER. 


Integument  covering  the  dorsal  region. 
Trapezius:  its  shape,  location,  O.  I.  A. 
Latissimus  dorsi:  shape,  size,  location. 
Its  relation  to  axillary  boundary;  form. 
Levator  anguli  scapulae:  location,  0.  I.  A. 
Rhomboid  minor:  shape,  direction,  0.  I.  A. 
Rhomboid  major:  shape,  direction,  O.  I.  A. 
Nerves  seen  in  this  dissection;  source. 
Vessels :  their  sources  and  destination,  where  ? 
Deltoid  muscle:  shape,  location,  action. 
Its  relation  to  the  head  of  the  humerus. 
What  structures  does  this  muscle  conceal  ? 
Supra-spinatus:  its  location,  destination. 
Infra-spinatus :  location,  insertion,  action. 
Teres  minor:  origin,  insertion,  action. 
Teres  major:  relation  to  latissimus  dorsi. 
Subscapularis :  location,  origin,  insertion. 
Vessels  supplying  shoulder  joint;  source. 
Nerves  distributed  around  the  joint,  what  ? 
Supra-scapular:  source,  where  ?  to  what  ? 
Circumflex:  origin,  distribution,  name. 
Repeat  origin,  insertion  and  action  of  muscles. 

50 


ANTERIOR  BRACHIAL  REGION. 


Importance  of  this  region.     Why  % 
Accidents  occurring  in  venesection. 

1.  Injury  to  cutaneous  nerves — where  ? 

2.  Injury  to  the  median  nerve. 

3.  Injury  to  the  bicipital  aponeurosis. 

4.  Injury  to  the  lymphatics  of  the  arm. 

5.  Injury  to  the  brachial  artery — where  ? 
Veins  on  the  forearm  and  arm — where  ? 
Radial  two,  anterior  and  posterior;  union. 
Ulnar  two,  anterior  and  posterior;  union. 
Median,  median  cephalic,  median  basilic. 
Brachial  vein :  formation,  location,  size. 
Venae  comites  of  radial  and  ulnar  artery. 
Cutaneous  nerves :  what  and  where  found. 
Median  nerve:  location  at  elbow,  destination. 
Lymphatics :  where  found,  destination,  course. 
Brachial  artery:  location,  division — where  ? 
High  bifurcation:  importance — why  % 
Biceps  flexor  cubiti  muscle;  describe. 
Relation  of  vessels  and  nerves  to  the  muscle. 
Where  is  artery  most  superficial,  in  danger  ? 
Remainingmuscles  of  arm — describe. 

51 


DISSECTION  OF  FOREARM. 


Four  classes  of  muscles  on  the  forearm. 
Of  these,  2  are  on  the  front:  pronators  &  flexors. 
Pronators  two;  illustrate  their  action. 
Pronator  radii  teres:  origin,  direction,  inser. 
Pronator  quadratus:  location,   surg.  interest. 
Flexors  of  two  classes,  carpal  and  digital  fl. 
Short  flexors  inserted  into  metacarpal  bones. 
Flex.  carp.  rad.  palmaris  long.  flex.  carp.  uln. 
Illustrate  origin,  direction,  insertion,  action. 
Long  or  digital  flexors,  3;  location,  insertion. 
Their  relation  to  interosseous  membrane. 
The  blending  of  these  muscles  at  their  origin. 
Radial  artery:  its  location  and  course  to  wrist. 
How  concealed  where  it  cannot  be  felt. 
Its  branches  near  its  origin,  and  downwards. 
Superficialis  volse:  origin,  course,  anastomosis. 
Course  of  radial  artery  to  its  termination. 
Formation  of  deep  palmar  arch;  branches. 
Ulnar  artery :  origin,  direction,  location,  under. 
Its  branches,  recurrent,  interosseous;  course. 
Course  of  artery  to  the  wrist,  how  concealed. 
Important  irregularity  in  course  from  elbow. 

52 


FOREARM,  Continued. 


Nerves  on  the  forearm:  what?  where  ? 
Cutaneous  nerves :  origin,  distribution. 
Ulnar  nerve:  location  at  elbow;  where  ? 
Its  course  towards  wrist;  how  concealed. 
Its  relation  to  ulnar  artery;  where?  how  ? 
Median  nerve:  location  at  bend  of  arm. 
Its  course  downwards  to  the  wrist;  trace. 
Where  enter  the  palm;  in  company  with  what? 
Branches  along  the  forearm;  to  what  ? 
Radial  nerve:  location;  from  what  source? 
Its  general  distribution  on  forearm. 
Its  relations  to  the  radial  artery:  where? 
Supinator  group  of  muscles:  two;  location. 
Origin,  direction,  insertion,  and  action. 
Extensor  group  of  muscles:  nine;  where? 
Short  extensors;  three;  to  metacapal  bones. 
Long  extensors;  three;  to  digits,  flat. 
Oblique  extensors:  three;  to  thumb? 
Common  or  blended  origin  of  muscles. 
Arrangements  at  the  annular  ligament. 
Synovial  sheath;  formation  of  ganglion. 
Anterior  and  posterior  annular  ligament. 

53 


ANATOMY  OF  THE  HAND. 


Palmar  fascia :  its  attachments;  strength. 
Parts  lying  immediately  under  it. 
Superficial  palmar  arch:  location. 
How  formed?  digital  branches ;  where? 
Branches  from  deep  palmar  arch;  where  ? 
Formation  of  deep  palmar  arch;  how  ? 
Nerves  to  the  hand  and  digits ;  where  ? 
Median  nerve;  where  enter  the  palm  ? 
Its  position  in  the  palm;  branches;  what  ? 
Location  of  nerves  along  the  digits. 
What  digits  supplied  by  median  nerve  ? 
Ulnar  nerve:  where  enter  the  palm? 
Digits  supplied  by  ulnar  nerve. 
Flexor  muscles  to  digits:  three;  names. 
Flexor  sublimis  digitorum;  0.  I.  A. 
Arrangement  of  tendons  along  digits. 
Flexor  profundus  digitorum;  O.  I.  A. 
Arrangement  of  sheath  for  these  tendons. 
Lumbricales  muscles:  their  insertion. 
Arrangement  of  tendons  on  dorsum  of  hand. 
Relation  of  tendons  to  joints  of  digits. 
Interossii,  dorsal,  and  palmar,  location. 

54 


NERVOUS  SYSTEM. 


Cerebro-spinal,  and  ganglionic. 
Cerebro-spinal:  name  and  location. 
Cerebro-spinal  axis:  meaning  of  the  term. 
Cerebro-spinal  system:  what  it  includes. 
Mode  of  opening  cranium:  object. 
Structures  concerned  in  protecting  the  brain. 
Hair  and  scalp :  influence  in  protecting. 
Cranium:  thickness  of  bones;  strength. 
Its  different  layers :  diplce;  object. 
Interior  of  skull,  everywhere  arched. 
Encephalon:  meaning  of  the  term. 
Membranes,  and  blood-vessels  included. 
Dura-mater,  arachnoid,  and  pia-mater. 
Nature  and  purpose  of  dura-mater. 
Its  relations  to  cranium  at  top,  and  base. 
Channels  within  it,  nature  and  purpose. 
Internal  reflection,  falx.,  tentorium,  object. 
Arachnoid:  location,  extent,  character. 
Its  relation  to  pia-mater;  subarachnoid  space, 
Pia-mater:  relation  to  brain,  extent,  object. 
Arteries  to  supply  brain:  place  of  entrance. 
Arrangement  in  pia-mater;  purpose. 

55 


NERVOUS  SYSTEM,  Continued. 


Brain — four  parts  included  in  the  term. 
Cerebrum:  its  division  into  hemispheres. 
Division  of  hemisphere  into  lobes — three. 
Lobes  made  up  of  convolutions. 
Convolutions  made  up  of  gray  and  white  matter. 
Great  median  fissure;    where  ?  how  occupied  ? 
Convoluted  surface  of  brain;  where  found  ? 
Depth  of  sulci,  and  arrangement  of  gyri. 
Commissura  magna,  or  corpus  callosum. 
Slice  through  the  hemisphere;  centrum  ovale. 
Ventricles  of  the  brain;  number,  nature. 
Roof  of  lateral  ventricle;  how  formed  ? 
Parts  seen  in  floor  of  the  ventricle. 
Corpus  striatum;  where?  appearance. 
Tenia  semicircularis ;  where  ?  shape. 
Optic  thalami;  where?  appearance. 
Lateral  ventricles;  how  separated  ? 
Septum  lucidum;  fifth  ventricle  between. 
Fornix;  its  shape  and  location. 
Choroid  plexus;  where,  what  is  it  ? 
Velum  inter-positum;  nature. 
Venae  GfaJeni;  direction  of  blood. 

5Q 


DISSECTION  OF  BRAIN,  Continued. 


Third  ventricle;  location,  communications. 

Foramen  com.anterius  or  iter  ad  infundibulum. 

Foramen  com.  posterius,  to  fourth  ventricle. 

Corpora  quadrigemina\  their  location,  shape. 

Cornna  from  lateral  ventricles;  where  end. 

Fourth  ventricle;  location,  how  shown  ? 

Relations  to  pons  Varolii  and  Med.  oblongata. 

Removal  of  brain  to  show  base  and  nerves. 

Principle  of  numbering  cranial  nerves. 

Remove  and  show  direction  of  nerves  to  exit. 

Parts  shown  as  the  brain  is  removed. 

Cerebellum-,  location,  how  protected  '\ 

Lateral  lobes;  superior  and  inferior  ver.  proc. 

Laminated  character  of  surface;  Arbor  Vitse. 

Pons  Varolii;  relation  to  cerebellum;  where  ? 
Its  structure,  connection;  direction  of  fibres. 

Medulla  oblongata;  location,  connections. 

Division,  crossing  of  its  fibres,  where  ? 

Corpus  pyram.,  connections  above  and  below. 

Corpus  olivare;  shape,  location,  grooves. 

Corpus  restiforme;  appearance,  where  ? 

Posterior  pyramidal  body,  bounds  ventricle. 

57 


SPINAL  CORD. 


Provision  for  its  protection;  nature. 
Its  location,  size,  enlargements. 
Its  length  in  the  infant  and  adult. 
Its  enveloping  membranes;  object,  strength. 
Theca  vertebralis,  relation  to  dura  Mater. 
Its  relation  to  the  bones  and  to  the  cord. 
Exit  of  nerves  from  it;  sheath  of  nerves. 
Relation  of  this  sheath  to  vertebrae;  object. 
Arachnoid,  subarachnoid  space,  where  \ 
Pia  mater;  structure,  relation  to  cord. 
Ligamenta  denticulata;  where  ?  object. 
General  appearance  and  structure  of  cord. 
Essentially  a  series  of  ganglia  in  line. 
Median  fissures  of  the  cord,  ant.  and  post. 
Lateral  partial  groves — three  columns. 
Anterior,  lateral  and  posterior  columns. 
Origin  of  roots  of  nerves;  appearance. 
Direction  of  roots  in  different  regions. 
Place  of  union;  where  %  ganglion  on  root. 
Do  these  ganglia  belong  to  sympath.  system  ? 
Arrangement  of  nerves  as  they  emerge. 
Divisions,  cervical,  dorsal,  1  unbar,  sacral. 

58 


COLUMBIA  UNIVERSITY  LIBRARIES 

This  book  is  due  on  the  date  indicated  below,  or  at  the 
expiration  of  a  definite  period  after  the  date  of  borrowing,  as 
provided  by  the  rules  of  the  Library  or  by  special  arrange- 
ment with  the  Librarian  in  charge. 

DATE  BORROWED 

DATE  DUE 

DATE  BORROWED 

DATE  DUE 

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A  brief 

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lectures  on  anatomy. 


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